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Haemodynamics after distal splenorenal shunt
Acta Chirurgica Scandinavica
|January 1, 1984
Summary
Distal splenorenal shunt surgery in cirrhotic patients effectively reduced portal pressure. Post-surgery, portal flow direction varied, but liver disease progression remained the primary driver of portal circulation changes.
Area of Science:
- Hepatology
- Vascular Surgery
- Gastroenterology
Background:
- Cirrhosis leads to increased portal pressure and altered blood flow.
- Distal splenorenal shunt is a surgical option for managing portal hypertension.
Purpose of the Study:
- To evaluate the haemodynamic effects of distal splenorenal shunt in cirrhotic patients.
- To investigate changes in portal flow direction and collateral formation post-surgery.
Main Methods:
- Haemodynamic studies conducted preoperatively and postoperatively (7-62 months) in 17 cirrhotic patients.
- All patients underwent distal splenorenal shunt surgery.
- Portography via percutaneous transhepatic portal vein cannulation assessed portal flow.
Main Results:
- All shunts were patent. Portal pressure significantly decreased post-surgery (p<0.01).
- Postoperative portal flow was hepatopetal in 9 patients and reversed in 8.
- Collateral formation was observed, but no gastroesophageal connections were evident in either group.
Conclusions:
- Distal splenorenal shunt effectively reduces portal pressure in cirrhosis.
- Progression of liver disease and increased liver resistance are key factors influencing portal circulation changes post-shunt.